Department of Obstetrics and Gynecology (A.-S.v.W., C.A., H.W.M., W.B.), Columbia University, New York, NY.
Department of Civil Engineering and Engineering Mechanics (M.K., I.A.K.), Columbia University, New York, NY.
Hypertension. 2024 Dec;81(12):2510-2519. doi: 10.1161/HYPERTENSIONAHA.124.23321. Epub 2024 Oct 15.
Preeclampsia is associated with autonomic dysregulation during pregnancy; however, less is known about autonomic function in the first week postpartum after preeclampsia.
We retrospectively analyzed data from a prospective cohort of women with and without preeclampsia. Continuous blood pressure and heart rate were measured with finger plethysmography within 7 days postpartum. Frequency-domain blood pressure and heart rate variability (HRV) were calculated using spectral analysis. Time-domain HRV was calculated as the root mean square of successive R-R interval differences. We compared results between those with and without preeclampsia, as well as between those with new-onset preeclampsia, chronic hypertension with superimposed preeclampsia, and normotensive participants.
A total of 70 postpartum women were enrolled: 20 normotensive, 29 new-onset preeclampsia, and 21 superimposed preeclampsia. Both low- and high-frequency blood pressure variabilities were higher in those with preeclampsia compared with controls (=0.04 and =0.02, respectively). This difference was driven by those with new-onset preeclampsia. The preeclampsia group had lower high-frequency HRV (<0.005), a higher low-/high-frequency ratio of HRV (<0.005), and lower time-domain HRV (=0.01); this difference was seen in those with and without chronic hypertension.
Postpartum patients with preeclampsia with and without chronic hypertension had lower HRV compared with normotensive postpartum controls. Higher blood pressure variability was observed only in those with nonsuperimposed preeclampsia, suggesting that the autonomic profile of preeclampsia may differ in patients with chronic hypertension.
子痫前期与妊娠期间自主神经失调有关；然而，子痫前期后产后第一周自主神经功能的情况了解较少。
我们对患有和不患有子痫前期的前瞻性队列研究中的数据进行了回顾性分析。在产后 7 天内，使用手指容积描记法连续测量血压和心率。使用频谱分析计算频域血压和心率变异性（HRV）。通过计算连续 R-R 间期差值的均方根来计算时域 HRV。我们比较了有和无子痫前期、新发子痫前期、慢性高血压合并子痫前期和正常血压参与者之间的结果。
共有 70 名产后妇女入组：20 名正常血压、29 名新发子痫前期和 21 名合并子痫前期。与对照组相比，子痫前期患者的低频和高频血压变异性均较高（=0.04 和=0.02）。这种差异是由新发子痫前期患者驱动的。子痫前期组高频 HRV 较低（<0.005），低频/高频 HRV 比值较高（<0.005），时域 HRV 较低（=0.01）；这种差异在有和无慢性高血压的患者中均可见。
与正常血压的产后对照组相比，患有和不患有慢性高血压的产后子痫前期患者的 HRV 较低。仅在无合并子痫前期的患者中观察到较高的血压变异性，这表明子痫前期的自主神经特征可能在患有慢性高血压的患者中有所不同。
